| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5105 |
Day care services, center-based; services not included in program fee, per diem |
47,933 |
5,154 |
$2.50M |
| T2003 |
Non-emergency transportation; encounter/trip |
12,791 |
1,452 |
$357K |
| S5102 |
Day care services, adult; per diem |
1,446 |
170 |
$138K |
| A0110 |
Non-emergency transportation and bus, intra or inter state carrier |
4,555 |
585 |
$117K |
| S9977 |
Meals, per diem, not otherwise specified |
7,931 |
946 |
$116K |
| A0100 |
Non-emergency transportation; taxi |
1,833 |
193 |
$46K |
| S5170 |
Home delivered meals, including preparation; per meal |
52 |
15 |
$384.00 |